The Functional Outcome of Four - in - One Technique: Dorsal Closing - Wedge & Shortening Osteotomy, Debridement, Micro - Fracture in the Treatment of Freiberg’s Disease

Introduction: Osteochondritis dissecans of the femoral condyles is a subchondral bone necrosis, rare, more or less extended. The osteochondral fragmentation that results from it is responsible for very invalid pain and joint dysfunction. The aim of this work is to eval uate the clinical, radiological and evolutionary aspects of patients operated for osteochondritis dissecans of the femoral condyles by the technique of mosaicplasty at Order of Malta's Hospital Center in Dakar CHOM. Patients and Method: This is a retrospe ctive, single - center study over a period of 67 months, involving 8 patients (6 men and 2 women). The average age was 25 years and the average BMI 22.93. Standard radiography has been performed in all our patients. 2 patients had MRI and 1 patient did a CT. The collected data were the time of care, the IKDC score, the ICRS score and the Hughston / SFA score. The following characteristics of the lesion - the surface and the location - were also studied. Intraoperatively, the number and diameter of the pads, t he location of the donor site and the associated operative procedures were recorded. At last follow - up, patients were assessed according to the Hughston functional and radiological scores, and IKDC. All the patients were immobilized for 6 weeks and benefit ed from the re - education sessions. Results: At an average follow - up of 36.5 months, the subjective results of the patients were very satisfactory in 62.5% of the cases and the clinical results according to the IKDC were excellent. Healing of osteochondral lesions was achieved in all our patients and 75% were in stage IV according to the radiological Hughston score.